Verapamil and migraine prophylaxis: mechanisms and efficacy

Article Abstract:

Migraine headache, a severe form of headache of unknown cause and characterized by nausea, vomiting, lightheadedness, sensitivity to light, visual disturbances and other symptoms, afflicts between 10 and 20 percent of the population of the United States. It is thought that dilation of cranial arteries, which often precedes the onset of a migraine attack, may be involved in bringing about this type of headache. One traditional therapy for migraine has been the administration of beta blockers, which inhibit excessive cerebral vasodilation (relaxation of the blood vessels). These drugs are effective in blocking migraine headache in up to 80 percent of patients, but some migraine side effects (i.e. nonheadache phenomena) may actually be worsened by beta blocker administration. Antidepressant drugs, such as compounds that block the inactivation of the neurotransmitter serotonin (e.g. tricyclic antidepressants), are also effective in many migraine patients. The drawback to currently available preventive treatments for migraine is the number of severe side effects of many available compounds, which include drowsiness, impotence, and blood vessel toxicity; they often must be avoided with many common disease states, as well. A class of drugs known as calcium channel blockers, which are widely used in the treatment of cardiovascular disorders such as high blood pressure, appears to hold promise in the treatment of migraine. In particular, verapamil, a calcium channel blocker with a very low incidence of side effects, is effective in preventing or ameliorating migraine in a significant percentage of patients. Verapamil may exert its antimigraine action by relaxing cerebral arteries and by interacting with nerve signal transmission involving these arteries. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Drug therapy, Migraine, Calcium channel blockers, Verapamil

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Altered insulin sensitivity, hyperinsulinemia, and dyslipidemia in individuals with a hypertensive parent

Article Abstract:

It is possible that the offspring of hypertensive people are in a stage of prehypertension, even when their blood pressure is normal. This could be true if insulin resistance precedes hypertension and obesity, and is not caused by these conditions. (Insulin resistance is the inability of insulin to affect glucose utilization in cells.) Seventy healthy, nonobese people with hypertensive parents were compared with 78 people (controls) whose parents had normal blood pressure with respect to insulin sensitivity, blood insulin and glucose levels, and blood lipoprotein levels (not all tests were carried out in all subjects). Participants ate a standardized diet for three days before each test was performed. Systolic blood pressure was slightly higher in the offspring of hypertensive parents; no differences were seen in diastolic blood pressure, heart rate, or fasting blood glucose concentrations. Children of hypertensive parents had increased fasting insulin levels, as well as higher levels of total triglycerides and total cholesterol; low-density lipoprotein or LDL cholesterol; very-low-density-lipoprotein or VLDL cholesterol; and total/high-density lipoprotein (HDL) cholesterol or LDL plus VLDL/HDL cholesterol ratios. These subjects also had lower insulin sensitivity indexes and higher basal and postglucose-load (after ingestion of glucose) blood insulin levels. The findings show that young people with normal blood pressure and good health with one hypertensive parent have subtle disturbances of glucose metabolism and blood insulin and fat levels. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Hypertension, Genetic aspects, Lipids, Insulin

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